APPLICATION FOR ENROLLMENT - Rich Falk Basketball Camp

1 APPLICATION FOR ENROLLMENT MAIL TO Rich Falk Basketball Camp Box 201 Glenview, Illinois 60025 Phone: (847) 205-1667 or (630) 673-1552 Today s Date: Recommended by: Resident Camper: $595 One Session (Full Payment) or ($200 Deposit) Resident Camper: $585 x 2 Both Sessions (Full Payment) or ($400 Deposit) Commuter Camper: $545 One Session (Full Payment) or ($200 Deposit) Commuter Camper: $535 x 2 Both Sessions (Full Payment) or ($400 Deposit) PLEASE ENROLL THE FOLLOWING CAMPER FOR 2018 (ENCLOSE FULL TUITION AMOUNT or DEPOSIT AMOUNT) July 15-19, 2018 July 22-26, 2018 Both Sessions Name: Age at Camptime Home Address: City, State, Zip: Phone Number: ( ) Parent E-Mail Address: Grade Next Year: School Name: Previous Camper at Rich Falk Basketball Camp: Yes No Roommate Preference (request only one) Friends or groups may request rooms next to one another Consenting Parent or Guardian Signature: Please send additional brochure(s) for my friend(s).

2 Note: We are expecting a full camp and ENROLLMENT is limited. Please pay the full tuition with this APPLICATION or any balance due (less your deposit) by April 1, 2018. Any camper APPLICATION after April 1 must include full tuition payment. Even with advance notice, $100 of full tuition or deposit is nonrefundable due to pre-camp reservation/administration costs. If your session is closed when your APPLICATION is received, we will call to discuss your options, including being added to a waiting list. If you cancel on or after the first day of camp, a fair refund will be returned, less the $100 administrative charge and any other costs incurred. NOTE: THIS CAMP IS NOT A FUNCTION OF TRINITY INTERNATIONAL UNIVERSITY.